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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604544
Report Date: 02/26/2025
Date Signed: 02/26/2025 02:30:58 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/03/2024 and conducted by Evaluator Alyssa Ramirez
COMPLAINT CONTROL NUMBER: 08-AS-20240503112011
FACILITY NAME:PACIFICA SENIOR LIVING BONITAFACILITY NUMBER:
374604544
ADMINISTRATOR:REBECCA TOVESFACILITY TYPE:
740
ADDRESS:3434 BONITA ROADTELEPHONE:
(619) 476-9444
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:145CENSUS: DATE:
02/26/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Services Director Abraham BotelloTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff are not esnuring that residents recieve incontinence care
Staff do not ensure the care needs of residents are being met
Staff do not ensure residents room is kept in safe, clean, sanitary conditions
Staff do not ensure call system alerts are responded to in a timely manner for residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alyssa Ramirez conducted an unannounced complaint visit to deliver findings on the above allegations. LPA met with Dining Services Director Abraham Botello and discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegations. The investigation consisted of records review, interviews with facility staff and outside sources.

It was reported to CCL that staff are not ensuring that residents receive incontinence care, staff do not ensure the care needs of residents are being met, staff do not ensure that resident rooms is kept in safe, clean, sanitary conditions and staff do not ensure call system alerts are responded to in a timely manner.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20240503112011
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: PACIFICA SENIOR LIVING BONITA
FACILITY NUMBER: 374604544
VISIT DATE: 02/26/2025
NARRATIVE
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Regarding the allegation that staff are not ensuring that residents receive incontinence care, it was reported that reporting party (RP) has visited a resident (R1) at the facility and has found R1 to be left in soiled clothing. Interview’s with outside sources revealed no concern for lack of incontinence care for residents. Interview’s with residents revealed no concern for resident incontinence care. Interview’s with facility staff revealed no concern for lack of incontinence care.

Regarding the allegation that staff do not ensure the care needs of residents are being met, it was reported that RP went to visit R1 and found R1 soiled on the floor. It was reported that a staff was observed exiting R1’s room and did not clean or assist R1 off the floor. Interview’s with residents revealed no concerns for staff not ensuring that their care needs are being met. Interviews with facility staff revealed no concern for staff not meeting resident’s needs. Interviews with outside sources revealed no concerns.

Regarding the allegation that staff do not ensure that resident room is kept in safe, clean and sanitary conditions, it was reported that R1’s room has a foul smell of urine and feces and has dirty clothing. LPA conducted unannounced visits and observed R1’s room along with other resident rooms. LPA did not smell any foul odors and did not see anything of hazardous conditions. Interview’s with facility staff revealed no concerns for cleanliness of resident rooms. Interview’s with residents revealed no concerns. Interview’s with outside sources revealed no concerns.

Regarding the allegation that staff do not ensure call systems alerts are responded to in a timely manner for residents in care, it was reported that R1 has used their call pendant to alert staff when they have fallen but staff do not come. A review of facility records show when call alerts were activated but are not time stamped when they are cleared. Interview’s with outside sources revealed no concern for response times for call button alerts. Interview’s with residents revealed no concern with response times for call system alerts.

Based upon the foregoing, the above listed allegations are unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegations are not valid. No deficiencies were cited today.



An exit interview was conducted with Botello. A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Botello whose signature below verifies receipt of these rights.

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2